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Abstract

Literature on stress and intimate partner violence (IPV) has primarily focused on stress as an outcome of women’s experience of IPV. However, stress may also be a predictor of male-perpetrated IPV. To improve our understanding of how theoretical approaches to stress have been applied to IPV research, we conducted a sub-analysis of a broader systematic review to identify published literature that examines theoretical approaches to stress as a predictor of male-perpetrated IPV. We conducted a search of nine electronic databases and assessed title/abstract and full texts according to pre-defined inclusion and exclusion criteria. Two reviewers categorized included studies into different theoretical groupings and sub-groupings. Data were extracted according to a data extraction template developed for the review, establishing consistency in a pilot data extraction phase. The review identified 27 articles that addressed the following theories of stress: general stress theory, life course theory, occupational stress theory, vulnerability theory, and family stress theory. Each of these sub-theories focuses on different forms of stress, for example, life course theory specifically focuses on stressful early life experiences, including adverse childhood events, whereas occupational stress theory focuses on workplace-related stressors that may result in increased male-perpetrated IPV. Analysis of measurement of stress variables indicated that measurement of stress varies widely across studies and primarily relies on self-reports. Consideration of stress as a predictor of IPV provides important insights into preventable and modifiable targets for intervention. Additional research on mechanisms and pathways between stress and IPV is needed.

Keywords

intimate partner violence domestic violence perpetration stress/stressors aggression mental health

Background

Stress is associated with a number of detrimental mental and physical health outcomes across the life course and is implicated in unhealthy and risky behaviors (Lovallo, 2005). There is a considerable evidence base on the associations between adverse childhood experiences (ACEs)—a set of stressors including poor caregiver mental health, physical and emotional neglect, and family members’ use of alcohol or drugs—and poor physical and mental health throughout the life course (Nelson et al., 2020). These ACEs have also been found to be associated with an increased risk of perpetrating interpersonal violence (Brown et al., 2023; Duke et al., 2010).

Intimate partner violence (IPV) is a highly prevalent human rights violation and global public health concern (Sardinha et al., 2022). While IPV can be experienced and perpetrated by both men and women, women are more likely to sustain serious injuries due to male-perpetrated IPV (Felson & Cares, 2005), and men are more likely to perpetrate severe and chronic IPV in the context of seeking and maintaining control and power within an intimate relationship (Kimmel, 2002; Warner, 2010). The vast majority of literature that focuses on stress and IPV considers IPV itself as the stressor and examines the mental health and coping outcomes of women who experience IPV (Chandan et al., 2020; Oram et al., 2017; Trevillion et al., 2012). For example, multiple studies have focused on how IPV experiences shape women’s mental health, and how stressors related to stigma, community norms, and socio-economic deprivation may limit women’s help-seeking behaviors following IPV experience (Murvartian et al., 2023; White et al., 2023; Wood et al., 2019; Wright et al., 2021).

Stress is defined as “a process by which external, environmental, or psychological demands” overwhelm an individual’s coping capacity and can result in social, biological, and psychological changes that are detrimental to health (Surachman & Almeida, 2018). Stress research posits that stress is comprised of three components: (a) stressors, which are external or environmental demands; (b) stress appraisals, which are individual perceptions and subjective experiences of the severity of the stressors; and (c) response to stressors, which may be behavioral, biological, or psychological (Cohen et al., 1997). Stress theorists emphasize that stress results in a physiological or behavioral response due to external stimuli, which may be unpredictable and/or uncontrollable (Koolhaas et al., 2011).

Cohen et al. note that there are three over-arching theoretical approaches to stress. The psychological stress perspective is focused on “individuals’ appraisals of stressors and the availability of coping resources to manage the overwhelming demands of such stressors,” while the social stress perspective emphasizes “the way that environmental or external demands precipitate individuals’ stress and how such demands are contingent upon contextual factors or social circumstances.” The third theory, the biological stress perspective, focuses on “how and when physiological systems become activated by stress processes” (Cohen et al., 1997).

Khrone, in contrast, outlined two paradigmatic approaches to stress: the systemic theory of stress, primarily based on psychobiology and physiology, and the psychological approach, developed by Lazarus (Krohne, 2001). While the systemic theory of stress, developed by Selye, hypothesized a general response pattern to stress, Lazarus’ theory emphasizes that stress is an interaction between the individual and the environment, and that stress appraisal—the individual’s perception of a particular event or experience—is key in determining how stress will relate to future health and well-being (Lazarus, 1991). Differences in individual appraisals of specific stressors can explain how individuals are differentially impacted by the same stressors and point to a role for situational and personal factors in determining responses to stress (Krohne, 2001). Lack of capacity to cope with stress can result in maladaptive behaviors, which occur when stressors “overburden” the capacities of an individual to cope (Gordon et al., 2021). Resource theories of stress, which focus on how well-being can be maintained in the presence of stressors, examine variables such as social support and self-efficacy as factors that can buffer the impacts of stressors on well-being (Krohne, 2001).

Stress is clearly an outcome of women’s IPV experience, but may also play an important role as a predictor of men’s perpetration of IPV against women. There are a number of potential explanatory mechanisms through which stress may influence male IPV perpetration. Some evidence indicates a biological process; a study, comparing IPV perpetrators to non-perpetrators, found differences in autonomic nervous system activation, whereby proactively violent men exhibit a different pattern of autonomic nervous system dysregulation than reactively violent men (Vitoria-Estruch et al., 2018). Hormonal and neuropsychological impairment when encountering stress may be higher among men who perpetrate IPV, and specific cognitive patterns, including poor empathetic skills and lack of problem-solving skills, that emerge in response to stressful events or circumstances may correlate with IPV perpetration (Romero-Martínez et al., 2013, 2021).

Mechanisms also include linkages between childhood adversity, other stressors, and IPV perpetration among men. Childhood experience of adversity is often associated with subsequent stressful life events and processes, such as men’s experience of financial stress, which in turn “may undermine their capacity to manage problems or conflicts effectively,” resulting in increased IPV perpetration (Hammett et al., 2020). Literature on economic factors predictive of male perpetration of IPV has found that stressors such as unemployment and absolute lack of resources are significantly associated with increased IPV perpetration (Awungafac et al., 2021; Gibbs et al., 2018; Hatcher et al., 2022). Another potential mechanism linking stress and male IPV perpetration is masculinity discrepancy stress, a form of stress emerging from self-perceived failure to adhere to dominant norms of masculinity; Reidy et al. (2014) found associations between discrepancy stress and male-perpetrated physical, psychological, and sexual IPV (Reidy et al., 2014). In addition, stress may influence male IPV perpetration through relationship quality and dynamics. A range of stressors can have a negative impact on interpersonal relationships, which in turn results in increased male IPV perpetration (Bradley, 2007; Jones, 2012).

Some existing systematic reviews have addressed the role of stress in IPV perpetration. Yim and Kofman’s systematic review of psychological and biological correlates of IPV experience identified 53 studies that included either a biological correlate (endocrine and immune/inflammatory system outcomes) or a psychological stress correlate (including perceived stress, stressful life events, and chronic stress) of IPV. Their review found that the vast majority of studies examined stress as an outcome of IPV, whereas only two studies using psychological stress correlates examined stress as a precursor to IPV experience longitudinally (Yim & Kofman, 2019). Keilholtz et al.’s meta-analysis assessed the association between a range of common life stressors (general stress, work stress, unemployment, low income, mental and/or physical health problems, and relationship distress) and male- or female-perpetrated IPV (Keilholtz et al., 2022), finding that all these forms of stress were significantly associated with male IPV perpetration. The same study also found that general stress, low income, mental health distress, and unemployment were all associated with elevated risk for women’s experience of IPV (Keilholtz et al., 2022). Their meta-analysis was based on Lazarus’ transactional theory of stress, and only included a specific set of life stressors. The systematic review presented in this article differs from the existing reviews in that the focus is on stress as a predictor of IPV, in contrast to Yim and Kofman’s review, and also, that it is inclusive of any form of stress theory or set of stressors, in contrast to Keilholtz’s review.

The operationalization and measurement of stress within empirical studies have been largely influenced by the varied theoretical conceptualizations of stress utilized in specific studies. Given the impact of how stress is measured on relevant research findings regarding the role of stress as a predictor of IPV against women, a description of how stress is measured and operationalized within empirical studies is central to improving the evidence base. Keenan et al. pointed out that stress exposure is often measured using events scales, which ask the respondent whether or not they have experienced a specific event. Events scales do not consider “type, timing, or chronicity of exposure,” which may have important impacts on how or if stress is associated with male IPV perpetration (Keenan et al., 2021). Which measure is selected depends largely on how specific stress theories define and operationalize stress. For example, utilization of an event’s scale emerges from a systemic stress approach (Selye, 1976), which assumes that the same life stressor will have a similar impact on any individual, whereas appraisal of stressful events and coping mechanisms would be assessed if a psychological approach to stress is being employed (Lazarus, 1966).

Schwartz et al. (2011) highlight a number of limitations concerning the measurement of stress, including the assumption that stress exposures are independent of each other and that the risk of impact of stress exposure on health outcomes is independent of the dosage of exposure. A recent review of the measurement of adult retrospective reports of ACEs identified major challenges in the measurement of stress exposure, including a lack of rigor in assessing timing and chronicity, reliance on retrospective recall, and lack of consistency in measurement (Krinner et al., 2021). Koolhaas et al. (2011) emphasize that poor measurement of stress can result in definitional challenges, given the presence of a stress response does not indicate the presence of a stressor, and accurate measurement of a stressor is needed in order to establish the association between exposure to a stressor and the stress response. Individuals’ subjective perceptions of a stressful event or stressor may be predictive of the severity of subsequent psychological and physiological responses, but subjective perception is less commonly measured in stress research (Koolhaas et al., 2011). Forms of coping, which broadly encompass emotion-focused and problem-focused coping, can be challenging to capture using self-reports, given individuals may not accurately recall or understand their own coping responses (O’Driscoll, 2013).

Where stress is implicated as a predictor of men’s perpetration of IPV against women or women’s experiences of IPV, it is essential for researchers, policymakers, and program designers and implementers to understand what type(s) of stress are important, how stress may intersect with other factors predictive of male perpetration of IPV, and what mechanisms link stress and IPV. Research on stress as a predictor of male perpetration of IPV is evident in the literature; however, comprehensive and systematic mapping of specific theoretical approaches to stress as a predictor of IPV is lacking. We conducted a systematic review of all theories that account for predictors of male-perpetrated IPV against women (Prospero registration: CRD42022316584) and analyze in this manuscript all articles that included a focus on stress theories. The systematic review focuses specifically on male-perpetrated IPV against women. There are major gaps in understanding men’s experiences of IPV, whether perpetrated by female or same-sex partners (Scott-Storey et al., 2022). Patterns and dynamics of IPV are influenced by gender and power dynamics, which entails that different theories may be needed to explain male versus female experience of IPV. Application of stress theory to understanding predictors of IPV overall is nascent, and therefore a focus solely on male-perpetrated IPV against women was deemed the most useful contribution to evidence synthesis. The objectives of the systematic review are (a) to identify and describe stress theories that account for predictors of IPV against women and (b) to describe how these stress theories operationalize and measure key concepts in IPV research.

Methods

We define predictors as variables that may increase or decrease the risk of women’s experience of IPV or men’s perpetration of IPV against women. The original protocol indicated that full data extraction would be conducted for quantitative empirical studies only if they were conducted in low- and middle-income countries (LMICs); however, the analysis deviated from the protocol in that full data extraction was conducted for all quantitative empirical studies, regardless of location.

Search Strategy

The following electronic databases were searched, using a structured search strategy: PubMed, PsycINFO, Embase, CINAHL, Social Work Abstracts, Social Services Abstracts, ProQuest Criminal Justice, Web of Science, and Applied Social Sciences Index and Abstracts. The search strategy included two key aspects: (a) search terms for IPV, and (b) terms for theory, theories, and theoretical, specifying that the theory term had to be included in the title or abstract. A full search strategy for one database, PubMed, is included as Supplemental File 1.

Eligibility Criteria and Screening

Eligibility criteria are described in the registered protocol. Briefly, studies were included if they presented empirical research addressing one or more theories of IPV against women or focused on theoretical discussions of predictors of IPV. Further inclusion and exclusion criteria are listed in Table 1. Inclusion criteria were selected to ensure that included articles had sufficient discussion and focus on theory, and that the subject was men’s perpetration of IPV against women (for reasons described earlier). Only peer-reviewed publications in the English language were included, given resources and time-frame available for the review. All search results were downloaded into Rayyan systematic review software, and duplicates were removed. Each title/abstract and full text was screened by two reviewers from the reviewer team. Where necessary, conflicts were resolved through discussions with the full team of co-authors, and a member of the team was designated as a third reviewer for every conflict, in order to determine inclusion or exclusion. Two reviewers (S.R.M., S.H.) conducted the categorization of studies into specific theories and sub-theories. Each study was read to identify the over-arching theory(ies) addressed in the study (sociological theory, economic theory, feminist theory, psychological theory, biological theory, and dynamics and typologies of violence). Each study was labeled with the over-arching theory(ies) it addressed, as well as any sub-theory or sub-theories. Conflicts in this process of categorization were not resolved by a third reviewer due to limitations of time and capacity; however, both reviewers discussed any conflicts to come to a final consensus.

Table 1.

Inclusion and Exclusion Criteria.

Inclusion Criteria	Exclusion Criteria
The focus is on a theoretical discussion of predictors of IPV OR the focus is on empirical research addressing one or more theories of IPV against women (studies that include IPV alongside other forms of violence against women, such as non-partner violence, will be included)	The focus of study is consequences of IPV
The focus is on predictors of women’s experience of IPV and/or predictors of men’s perpetration of IPV against women	The population of focus is same-sex couples
Theory must be addressed at some length (at least a paragraph) in the introduction or discussion	The outcome of interest is violence against men (studies including IPV against men will be included if IPV against women is also addressed)
Peer-reviewed publication	The outcome of interest is only violence against women that does not occur in intimate relationships
The study is published in English	Type of publication: grey literature, theses, systematic reviews

Note. IPV = intimate partner violence.

Data Extraction and Analysis

For the purposes of the over-arching systematic review, we developed and piloted a data extraction template. Review team members extracted data from the same four articles in order to pilot the template, and the template was then refined based on comparing data extraction results to ensure consistency. For studies with quantitative empirical data, data were extracted on research objectives, study design, sample size and sampling approach, country, key theoretical constructs, measurement approaches, primary findings, and interpretation in relation to theory. We then used descriptive synthesis to explore and explain stress theories of predictors of IPV (Blundell, 2014).

Results

Database searches for the overall systematic review including all theoretical approaches identified 7,663 unique records, of which 6,922 were excluded during the title and abstract screening (see Figure 1). Seven hundred twenty-two records were retrieved for full-text review. Nineteen full texts could not be retrieved despite multiple efforts, including searching multiple databases and contacting authors directly. After a full-text review of the 722 full texts, 420 articles addressing any theories of predictors of IPV were included. Following theory categorization, 27 full texts were labeled as addressing stress theories, 19 of which included quantitative empirical data.

Figure 1.

PRISMA 2020 flow diagram for new systematic reviews that included searches of databases and registers only.

Table 2 displays which non-stress theories the included studies also addressed. Two of the included studies were published in the 1980s, 3 in the 1990s, 2 in the 2000s, 15 in the 2010s, and 5 thus far in the 2020s. The research objectives, study design, and country in which the study was conducted are displayed in Table 3 for manuscripts that employed quantitative empirical data. Five of the 19 empirical studies (26%) took place in or included LMICs, whereas 12 were conducted in the United States of America alone (44%).

Table 2.

Included Articles and Theories.

Article Author (Year)	Additional Theory/Theories	Empirical Data—Yes/No
Aborisade (2021)	Psychological theories—social learning theory Psychological theories—trauma theory Economic theories—resource theory Feminist theories—gender norms and masculinity Sociological theories—criminological theory	Yes—qualitative only
Anderson and Lo (2011)	Psychological theories—affect theory Sociological theories—criminological theory	Yes
Campbell et al. (1995)	Psychological theories—social learning theory Psychological theories—psychopathology and personality theories Feminist theories—power and control theory	No
Cheung et al. (2014)	Sociological theories—criminological theory	Yes
Chornesky (2000)	Psychological theories—attachment theory Psychological theories—family theory Psychological theories—psychopathology and personality theories Psychological theories—social learning theory Feminist theories—gender and power theory Feminist theories—gender norms and masculinity	No
Corvo and Johnson (2013)	Psychological theories—alcohol-use theories Psychological theories—social learning theory Dynamics and typologies of violence—perpetrator typologies Feminist theories—gender and power theory	No
Cudmore et al. (2017)	None	Yes
Davis et al. (2021)	Sociological theories—ecological theory	Yes
Eriksson and Mazerolle (2013)	Sociological theories—criminological theory	No
Fox et al. (2002)	Economic theories—resource theory Feminist theories—gender and power	Yes
Hackett (2011)	Feminist theories—gender and power Economic theories—resource theory Sociological theories—ecological theory	Yes
Hoffman et al. (1994)	Economic theories—resource theory Overlapping theories—status inconsistency theory	Yes
Iratzoqui and Watts (2019)	Psychological theories—trauma theory Sociological theories—criminological theory	Yes
Jones (2012)	Sociological theories—cultural theory Sociological theories—criminological theory Biological theories—evolutionary theory	No
Jones et al. (2018)	None	Yes
Jones et al. (2021)	None	Yes
Kennedy et al. (2017)	None	Yes
Kennedy et al. (2018)	None	Yes
Lucero et al. (2016)	Psychological theories—family theory	Yes
Macewen and Barling (1988)	None	Yes
Parker and Toth (1990)	Sociological theories—criminological theory	Yes
Petersen (1980)	Psychological theories—social learning theory	Yes
Ragetlie et al. (2021)	Sociological theories—ecological theory	Yes
Rao (2020)	None	Yes
Rodríguez-Menés and Safranoff (2012)	Economic theories—exchange theory Overlapping theories—status inconsistency theory Feminist theories—gender and power	Yes
Taillieu and Brownridge (2010)	Psychological theories—social learning theory	No
Tenkorang and Owusu (2018)	None	Yes

Table 3.

Empirical Studies: Study Design, Research Objective(s), and Setting.

Article Author (Year)	Study Design	Research Objective(s)	Setting	Strength of Association
Anderson and Lo (2011)	Cross-sectional study	To investigate how job-related stress affects the likelihood that police officers use physical violence against an intimate partner.	United States (urban)	Stress events and IPV perpetration: uOR: 1.08 (95% CI [1.02, 1.15]); aOR: 1.00 (95% CI [0.94, 1.07])
Cheung et al. (2014)	Cross-sectional study	To investigate whether husband’s degree of self-control is associated with perpetration of violence against his wife.	Hong Kong	Husband-to-wife psychological aggression OR: 0.93*; Husband-to-wife physical assault OR: 0.88*
Cudmore et al. (2017)	Cross-sectional study (secondary data analysis of Dating Violence Among Latino Adolescents Study)	To examine the association between polyvictimization and adolescent delinquent behavior, including violence-perpetration.	United States (rural and urban)	Polyvictimization and delinquency: aOR: 1.53***
Davis et al. (2021)	Cross-sectional study (secondary data analysis of International Dating Violence Study)	To explore whether overall well-being of a country (human development index, status of women) during childhood affects perpetration of IPV in adulthood, and whether national status of women during childhood moderates the relationship between overall well-being of a country and IPV perpetration.	Nineteen countries—Brazil, China, Germany, Greece, Guatemala, Hong Kong, Hungary, Indonesia, Korea, Lithuania, Mexico, Mali, Portugal, Romania, Russian Federation, Singapore, Tanzania, Venezuela, South Africa	High women’s status and IPV perpetration: OR: 1.53* (in countries where women’s status was low or moderate, the association between well-being and IPV was insignificant)
Fox et al. (2002)	Longitudinal (secondary data analysis of National Survey of Family and Households)	To examine the effects of different household economic indicators on the risk of IPV against women, including testing hypotheses that job strain and objective and subjective economic well-being are significant predictors of male-perpetrated IPV.	United States (rural and urban)	Job strain predictors (male): OR: 1.25**; Financial status predictors (male): OR: 0.81
Hackett (2011)	Cross-sectional study (secondary data analysis of National Crime Records)	To examine the relationship between a state’s level of development and rates of IPV and intimate partner homicide.	India (rural and urban)	For dowery deaths (intimate partner homicide): Indian states with higher “human,” “gender-equality,” and “urban development” have lower rates of Dowry Death crimes and vice versa; For cruelty (IPV): In states where “human” and “gender development” are higher, the Cruelty Ratio was lower and vice versa
Iratzoqui and Watts (2019)	Longitudinal (secondary data analysis of National Longitudinal Study of Adolescent to Adult Health)	To explore the associations between child maltreatment, dating violence, and IPV, including testing if dating victimization mediates the relationship between child abuse and IPV experience during adulthood.	United States (rural and urban)	Child abuse → Dating victimization b = 0.139; Dating victimization → Intimate partner victimization b = 0.479; Child abuse → Dating victimization → Intimate partner victimization b = 0.001*
Jones et al. (2018)	Cross-sectional study	To examine how individual, cumulative and clusters of adverse childhood events relate to multiple forms of IPV experienced during adulthood amongst women in correctional facilities in Oklahoma.	United States (correctional facilities)	Simple assault RR: 1.624*; Aggravated assault RR: 1.354; Sexual abuse RR: 3.024; Psychological abuse RR: 1.837*
Jones et al. (2021)	Cross-sectional study	To use a feminist life course perspective to explore the relationship between adverse childhood events, PTSD and adult IPV experience amongst women in correctional facilities in Oklahoma.	United States (correctional facilities)	ACEs → IPV victimization β = .36*; ACEs → PTSD β = .65; PTSD → IPV victimization β = .55**
Kennedy et al. (2017)	Cross-sectional study	To explore the effects of cumulative childhood victimization experience on IPV risk among young mothers.	United States (rural and urban)	Between-persons effects on IPV victimization γ = .04; Between-persons effects on the linear trajectory of change in IPV victimization γ = .05***
Kennedy et al. (2018)	Cross-sectional study	To examine rates and patterns of various forms of IPV, including co-occurrence, association with relationship length, and transitions in and out of violent relationships.	United States (rural and urban)	Physical IPV plus coercive control (21%); physical, sexual IPV and coercive control combined (19%); other combinations rare/non-existent; no significant differences in the rate of physical IPV, coercive control, or sexual IPV across different relationships
Lucero et al. (2016)	Longitudinal (secondary data analysis of Fragile Families and Child Well-being Study)	To identify the influence of changing subjective reports of economic hardship over time on IPV risk.	United States (urban)	Economic hardship: Decline B = 2.29*; Increase B = 2.63; Unstable B = 1.61; High throughout B = 2.55***
MacEwen and Barling (1988)	Longitudinal	To explore the prospective relationship between marital aggression (IPV) and multiple stress and violence in family of origin.	United States (urban)	Family of origin aggression affect risk of enacting later relationship aggression; if the amount of experienced aggression is high but the impact of that aggression is low, the likelihood of current relationship aggression is reduced
Parker et al. (1990)	Secondary data analysis of homicide data	To explore macro and micro risk factors associated with intimate partner homicide.	United States (urban)	Proportion Black, Southern region, Female labor force participation rate, Proportion age 20–34, Unemployment rate, Retail activity all significant risk factors for intimate partner homicide
Petersen (1980)	Cross-sectional study	To examine and test social learning theory (whether IPV is a behavior learned in the family of origin) and stress theory (the relationship between IPV and social class).	United States (rural and urban)	Social learning theory: Women whose fathers abused their mothers or who were themselves abused as children reported an incidence of wife abuse five times greater (44%) than that reported by women who did not have such backgrounds (8%); Women whose husbands came from families where one parent abused the other also reported a higher incidence of wife abuse (22%) than women married to men who did not come such violent families (7%); Stress theory: Women whose husbands were employed in white-collar occupations reported a much lower incidence of wife abuse than did those whose husbands worked in blue-collar occupations; Women who were married to men in stable employment reported a much lower incidence of abuse than those whose husbands were not employed steadily
Ragetlie et al. (2021)	Cross-sectional study	To investigate the association between household food production and IPV in Atacora, Benin.	Benin (rural)	Insufficient food production and IPV experience: Physical violence aOR: 6.50 (95% CI [2.48, 17.04]); Sexual violence aOR: 4.49 (95% CI [1.68, 11.99])
Rao (2020)	Longitudinal (secondary data analysis of three waves of National Family Health Survey)	To examine the association between natural disaster occurrence and IPV prevalence.	India (rural and urban)	Severely affected by natural disaster: Tamil Nadu aOR: 1.98**; Kerala aOR: 1.41; Moderately affected by natural disaster: Andhra Pradesh aOR: 1.85***; Not directly affected by natural disaster: Karnataka (reference)
Rodríguez-Menés and Safranoff (2012)	Cross-sectional study	To test five theories of causes of IPV against women: sexism, family violence, dependency, exchange and status inconsistency.	Spain (rural and urban)	The paper found support for theories that stress the role of patriarchy in fostering violence, and little support for family violence perspectives that claim that stressful family conditions nurture violence
Tenkorang and Owusu (2018)	Cross-sectional study	To examine if women’s childhood experiences of family violence are associated with their later experience of IPV.	Ghana (rural and urban)	No violence before but physical and/or sexual violence after age 15, Physical IPV aOR: 1.94; Sexual IPV aOR: 3.22; Psychological IPV aOR: 2.80; Violence before but not after age 15, Physical IPV aOR: 1.31; Sexual IPV aOR: 1.81; Psychological IPV aOR: 1.45; Violence before and after age 15, Physical IPV aOR: 2.45; Sexual IPV aOR: 4.18; Psychological IPV aOR: 3.60

Note. ACEs = adverse childhood experiences; aOR = adjusted odds ratio; CI = confidence interval; IPV = intimate partner violence; OR = odds ratio; PTSD = post-traumatic stress disorder; RR = risk ratio; uOR = unadjusted odds ratio.

p < .05. **p < .01. ***p < .001.

Descriptive Synthesis of Theories

Several sub-theories emerged through our analysis of included studies that addressed stress theory: general strain theory, life course theory, occupational stress theory, vulnerability theory, and family stress theory. These are each described in turn (Table 4).

Table 4.

Measurement of Key Variables.

Sub-theory	Key Variable	Measurement Approaches	Studies Utilizing This Approach
All sub-theories
	Stressful events	Index of stressful events and Likert scale to assess how respondent was emotionally affected by each event, continuous scoring.	Anderson and Lo (2011)
General strain theory
	Negative emotions	Eleven-item index created for study, assessed by Likert scale, continuous scoring.	Anderson and Lo, (2011)
	Strain	Dissatisfaction with family financial situation; Likert scale question of how satisfied respondent is with financial situation of their family.	Cheung et al. (2014)
		Dissatisfaction with relationship with spouse; Likert scale question on how satisfied respondent is with their relationship with partner.	Cheung et al. (2014)
		Physical abuse as a child; binary question.	Cheung et al. (2014)
		Polyvictimization, assessed using the Juvenile Victimization Questionnaire, covering four victimization categories: conventional crime, child maltreatment, sexual abuse, and peer/sibling victimization; operationalized as total number of events endorsed in each category.	Cudmore et al. (2017)
	Trauma	Child abuse ascertained through questions asking how often a parent had slapped, kicked, or hit, sexually touched them, forced the respondent to touch him or her in a sexual way, or forced sexual relations; dichotomized into ever experienced vs. never experienced.	Iratzoqui and Watts (2019)
	Anger	Five-item hostility sub-scale, from Brief Symptom Inventory; scored according to Brief Symptom Inventory scoring criteria and converted into published t-scores.	Cudmore et al. (2017)
	Anger	Assessed as protective factor, that is, ability to manage anger; three sub-scales, behavioral self-soothing, recognizing the signs of anger, and self-talk; scored as continuous variable.	Davis et al. (2021)
	Maladaptive coping	Delinquency; self-reported delinquency in the previous year, assessed with 21-item Frequency of Delinquent Behavior measure, which includes physically assaulting peers or adults, school truancy, shoplifting, or cheating on tests. Dichotomized variable for each of the delinquent behaviors assessed.	Cudmore et al. (2017)
	Maladaptive coping	Continuous score, calculated from: (a) Frequency of binge drinking: single question asking about having five or more drinks in a row in the past 12 months; (b) Running away from home: how often have run away from home in the past 12 months (0 = never to 3 = 5 or more times); (c) Selling drugs: how often have you sold marijuana or other drugs in the past 12 months (0 = never to 3 = 5 or more times).	Iratzoqui and Watts (2019)
	Negative emotions—depression, anxiety and negative expectations	Negative emotions: 22 items, including (a) being bothered by things that didn’t usually bother them, (b) having trouble keeping their mind on what they were doing, and (c) being tired. Responses ranged from 0 (never/rarely) to 3 (most or all of the time). Anxiety: included (a) fearfulness, and (b) having trouble relaxing. Responses ranged from 0 (never) to 4 (every day). Negative expectations: whether respondents thought that they would (a) go to college (reverse-coded), (b) want to go to college, (c) live to age 35 (reverse-coded), (d) be married by age 25, (e) be killed by age 21, and (f) achieve a middle-class income by age 30. Responses ranged from 1 (almost no chance) to 5 (almost certain).	Iratzoqui and Watts (2019)
Life course theory
	Childhood violence experience	The measure includes five subscales: Family, Nonfamily, Advised Violence, Witnessed Violence, Victim of Violence, Physical Maltreatment, that is, “When I was a kid, I often saw kids who were not in my family get into fights and hit each other”; scored as continuous variable.	Davis et al. (2021)
	Childhood violence	Six items, before age of 15 did an adult do any of the following: slapped/hit them with something/kicked/bit/punch/choke/burn; forced/attempt to have sex with them against their wish; performed any sexual act (kissing, fondling/touching) against their wish; refused to give them food/feeding money; controlled their own belongings/spending decisions; and destroyed or damaged your property. Created a binary variable—ever experienced childhood violence vs. not.	Tenkorang and Owusu (2018)
	Adverse childhood events	Ten adverse childhood events: physical neglect, emotional neglect, emotional abuse, physical abuse, sexual abuse, family member incarcerated, mother battered, parental separation and divorce, lived with someone with a mental illness, and lived with someone with a substance abuse; binary variable for each item.	Jones et al. (2018, 2021)
	Adverse childhood events	Cumulative adverse childhood events: high accumulation of adverse childhood events (5 or more) and low (0–4 adverse childhood events).	Jones et al. (2018)
	Adverse childhood events	Clusters of adverse childhood events: abuse (three items); neglect (two items); and chaotic home environment (five items). Continuous scoring for each cluster.	Jones et al. (2018)
	Exposure to community and school violence	Three items from the 20-item Things I have Seen and Heard scale (Richters & Martinez, 1990). Scored as continuous variable.	Kennedy et al. (2017)
	Physical maltreatment by a caregiver.	Three items from Conflict Tactics Scale—“During the year, did an adult whom you lived with or who was a family member ever do the following things to you:” and these questions: “grab, push, or slap you?” “punch or hit you?” and “beat you up?,” and added: “whether participants had been paddled or spanked hard enough to leave marks or bruises” (not in original Conflict Tactics Scale).	Kennedy et al. (2017)
	Physical violence (above aged 15)	If from age 15, any intimate partner other than current/last husband/partner did any of the following: (a) hit, slapped, or kicked; (b) threatened to hurt someone they cared about; (c) insulted or belittled them in public; (d) threatened to use a gun, knife, or other weapon against them. Binary variable—experienced physical violence if answered yes to any of the four questions.	Tenkorang and Owusu (2018)
	Witnessing IPV	Three items developed from Conflict Tactics Scale; In your family or the place where you were living that year, did you see or hear adults fighting in the following ways: (a) Getting grabbed, pushed, or slapped?; (b) Getting beaten up?; (c) Getting threatened with, or having a knife or gun used on them? Binary variables, if yes to any of them, considered exposed to witnessing IPV.	Kennedy et al. (2017)
	Witnessing IPV	One item, if respondents ever observed abuse/violence between their parents or other members of your household when they were children. Response categories include “yes, parents,” “yes, other members,” and “no.”	Tenkorang and Owusu (2018)
	Sexual victimization in childhood	Three items, each year since age of 5: That year, did anyone, (a) force you to touch yourself or touch their body?, (b) try to rape or sexually assault you (may be oral, vaginal, or anal)?, or (c) rape or sexually assault you? Binary variable, if yes to any of them, considered exposed to sexual victimization in childhood.	Kennedy et al. (2017)
	Sexual violence after age 15	If from age 15, any intimate partner other than current/last husband/partner did any of the following: (a) forced to have sexual intercourse with them when they did not want to; (b) forced them to perform sexual acts they did not want to; and (c) touched their body in a sexual way. Binary variable, if yes to any of them, considered exposed to sexual violence after age 15.	Tenkorang and Owusu (2018)
	Cumulative victimization	Summed the 13 items assessing each type of violence (three community and school violence items, three witnessing IPV items, four physical maltreatment items, and three sexual victimization items).	Kennedy et al. (2017)
	Life course experience of violence	Four categories of exposure: (a) No experience of childhood violence or physical and/or sexual violence after age 15; (b) No experience of childhood violence; physical and/or sexual violence after age 15; (c) Childhood violence, no experience of physical and/or sexual violence after age 15; and (d) Childhood violence and physical and/or sexual violence after age 15.	Tenkorang and Owusu (2018)
	Criminal history	Eight items, four subscales: Property Crime: I stole or tried to steal something worth more than U.S. $50, I stole money (from anyone, including family); Violent Crime: I have physically attacked someone with the idea of seriously hurting them, I hit or threatened to hit someone who is not a member of my family; Early Onset: Each item, before age 15; Later Onset: Each item, above age 15. Scored as continuous variable.	Davis et al. (2021)
	Neglect history	Unfulfilled cognitive, emotional, physical, and supervisory needs in the respondents’ family-of-origin; four subscales: Cognitive, Supervisory, Emotional, and Physical. For example, items included “My parents did not care if I did things like shoplifting,” and “My parents did not comfort me when I was upset.” Scored as continuous variable.	Davis et al. (2021)
Family stress theory
	Financial adequacy	Income-to-needs ratio, computed from the total household income divided by the poverty line for a similarly composed household; a count of up to seven kinds of current household debt (i.e., personal loans from banks or friends or credit card debt) and man’s contribution to couple earnings.	Fox et al. (2002)
	Financial well-being	Degree of satisfaction with current finances (7 = very satisfied) and frequency of worry about meeting expenses with current income (5 = never worry). Scored as continuous variable.	Fox et al. (2002)
	Economic stress	Human development Index calculated with a state’s female literacy rate, average marriage, fertility rate, infant mortality rate and female homicide rate.	Hackett (2011)
	Economic stress	Urban development index, calculated with percentage of a state’s population with electricity, percentage of state’s population living in urban areas and rate of full-time female workers.	Hackett (2011)
	Economic hardship	Ten items, originally used with the Survey on Income and Program Participation, including economic experiences in the past 12 months such as receipt of free food/meals; children or you go hungry; not pay full amount of rent/mortgage; not pay full utility bill; borrow money from family/friends; move in with people because of financial problems. Scored as continuous variable.	Lucero et al. (2016)
	Family-level socio-economic resources	Number of children, whether children living in the household are minors or adults, family income (markedly below, not far from, or markedly above Spain’s €900 average in 2006), rural or urban household location.	Rodríguez-Menés and Safranoff (2012)
	Women’s individual-level socio-economic resources	Age, marital status (single, divorced/separated, married, other), years with current partner, employment status, education (less than secondary, secondary, and more than secondary), native or immigrant status, years living in Spain, religious denomination, and regular attendance to religious services.	Rodríguez-Menés and Safranoff (2012)
	Food production	Single item, “Are you consistently able to produce enough food to meet the needs of your family throughout the year?,” four response categories: never, sometimes, often or always. Dichotomized into binary variable as producing enough food for “always” or “often,” and not producing enough food for “never” or “sometimes.”	Ragetlie et al. (2021)
	Unemployment	Unemployment rate measured via census data.	Parker and Toth (1990)
	Female labor force participation	Rate via census data.	Parker and Toth (1990)
	Social class	Education—Grades 0–8; Grades 9–11; High school graduate; 1–3 years college; College graduate; Graduate school.	Petersen (1980)
	Social class	Income—husband’s yearly income in six income categories.	Petersen (1980)
	Social class	Husband’s occupation—white-collar occupations (professional, management, sales, clerical) vs. blue-collar occupations (semiskilled workers, transport equipment operators, laborers, service workers).	Petersen (1980)
	Social class	Employment stability—steady, unsteady, mostly unemployed.	Petersen (1980)
	Social class	Homeownership—whether the male partner owns a house or not.	Petersen (1980)
	Parenting stress	Short version of Parenting Stress Index (Abinin, 1995); four statements about parenting stress, including being a parent is harder than I thought it would be and I feel trapped by my responsibilities as a parent, Likert scale response. Scored as continuous variable.	Lucero et al. (2016)
	Work stress	32-Item Organizational Change Inventory (Sarason & Johnson, 1979); asks about if an event occurs, and rate relative positive or negative impact of each occurrence.	Macewen (1988)
	Life stress	47-Item Life Experiences Survey (Sarason et al., 1978); asks about if an event occurs, and rate relative positive or negative impact of each occurrence.	Macewen (1988)
	Violence in family of origin	Experiencing violence: extent to which the respondent had been abused as a child (“how often were you hit by a parent?,” “how often were you beaten by a parent?,” “how often were you hit by a parent with a belt, stick or some other object?,” “how often did a beating result in cuts and/or bruises?”). Binary variable.Witnessed violence in the respondent’s family of origin (“how often did you see your parents argue?,” “how often did you see your father hit your mother?,” “how often did your father beat your mother?,” and “how often did your mother hit your father?”). Binary variable.	Macewen (1988)
	Marital satisfaction	Assessed using the 15-item Short Marital Adjustment Test, binary variable distinguishing between clinically distressed and non-distressed marriages.	Macewen (1994)
	Marital instability	Number of new divorces per year divided by number of new marriages per year; sourced from Vital Statistics data.	Parker and Toth (1990)
Disaster vulnerability theory
	Disaster exposure	Residence in a particular state used as proxy for 2004 tsunami-exposure; Kerala and Tamil Nadu classified as high impact, Andhra Pradesh as low impact and Karnataka as no impact.	Rao (2020)

Note. IPV = intimate partner violence.

General strain theory was first developed by Agnew (1992) to expand traditional strain theories to include frustrating aspects of daily life (Agnew, 1992; Cudmore et al., 2017). Sources of strain often revolve around the family and include child maltreatment, financial matters, household decisions, parenting approaches, marital satisfaction, infidelity, loss of a child, and relationship separation (Cheung et al., 2014; Eriksson & Mazerolle, 2013). General strain theory argues that strain produces negative emotions, and without effective coping mechanisms, this can lead to maladaptive coping, which includes “delinquent behavior” (Agnew, 1992). Corvo and Johnson (2013) describe coping as the ability to regulate internal states while under stress and identify IPV perpetration as a maladaptive coping strategy.

Several empirical studies tested the general strain theory. Cheung et al. (2014) utilized general strain theory to operationalize strain as dissatisfaction with family financial situation, childhood experience of physical abuse by parents, and dissatisfaction with marital relationship. Their results indicate that childhood experience of physical abuse and dissatisfaction with the marital relationship were significantly associated with male perpetration of IPV in Hong Kong. Iratzoqui and Watts (2019) found that maladaptive coping and negative emotions and expectations related to childhood experience of violence, a core form of strain within general strain theory, significantly predicted dating violence and IPV experience. This indicated support for the general strain theory’s concept that associations with IPV are not only due to the presence of stress but also about how individuals respond to these stressful experiences. Two studies assessed general strain theory among law enforcement officers in Baltimore, Maryland. One found a significant positive association between stressful events, self-reported negative emotions, and self-reported physical IPV perpetration (Anderson & Lo, 2011), and the other found that strain was indirectly associated with domestic violence through negative affect (anger and depression) (Gibson et al., 2001).

Life course theory was first developed by Elder as a theory focusing on developmental processes from childhood through adolescence to adulthood, and the social pathways, such as family, education, and work, that influence these developmental patterns within historical, sociocultural, and economic contexts (Elder, 1994; Elder et al., 2003). Life course theory proposes stressful life events can have significant impacts on processes and dynamics across the life course.

Given the important role of parental influence over the life course, early life experiences with violence can have long-lasting negative outcomes. A few of the included studies, conducted in both high-income and LMIC settings used life course theory and found that ACEs, including experiencing or witnessing family violence in early childhood, are positively associated with women experiencing adolescent dating violence or adult IPV (Jones et al., 2018, 2021; Kennedy et al., 2017; Tenkorang & Owusu, 2018). For example, one study with incarcerated women in Oklahoma found that post-traumatic stress disorder (PTSD) mediated the association between ACEs and adult IPV (Jones et al., 2021). Results from Tenkorang et al.’s study in Ghana were supportive of life course theory, in that both ACEs (violence experienced before the age of 15) and violence experienced after age 15 were predictive of women’s IPV experience (Tenkorang & Owusu, 2018).

Other stress theories focus on specific sources of stress. For instance, occupational stress theory examines stressors that individuals experience as part of their work. Certain occupations may inherently be more stressful than others. For instance, the military is generally considered a dangerous and stressful workplace environment. This occupational stress can negatively influence the home environment and interpersonal relationships (Perry-Jenkins et al., 2000). Men in such stressful, male-dominated occupations may be more likely to exert control using physical force in the course of their work and echo workplace behaviors through exerting violence against their partners at home (Jones, 2012), a process referred to as occupational violence spillover (Melzer, 2002).

Vulnerability theory, developed by O’Keefe et al. (1976), suggests that the impact of natural disasters is shaped by social determinants, and according to disaster vulnerability theory, systemic and societal factors increase the susceptibility of certain individuals and communities to greater harm and loss as a result of a natural disaster (Rao, 2020; Wisner, 2016). One study employed vulnerability theory, focusing on the prevalence and correlates of IPV in four Indian states after the 2004 Indian Ocean tsunami. Results indicated that IPV increased more in states more directly and severely affected by the tsunami, highlighting that gender inequality and women’s economic disadvantage may have been compounded by the disaster (Rao, 2020). Results also indicated that within states, regardless of tsunami impact, women from minority religions and historically disadvantaged caste groups were at higher risk of IPV, indicating intersections of stress and contextual factors.

Family stress theory pays close attention to stress markers, including class and gender inequality, within the family system. Applying family stress theory to IPV perpetration, Gelles explains that the family forms the primary social institution where social norms on violent behavior are taught and learned (Gelles, 1985). Gelles focused on the family unit as a location of potential stress, with family stress theory positing that the concentration of stressors due to economic deprivation and financial stress in lower socio-economic classes explains the higher prevalence of IPV among families with lower socio-economic status. These families may also have fewer resources—material, emotional, and social—to support coping with stress.

Several studies have tested the association of these family-level stressors, which include socioeconomic status, poverty, unemployment, low incomes, increased financial distress, unmet role expectations leading to frustration, economic hardship, and IPV (Fox et al., 2002; Hackett, 2011; Hoffman et al., 1994; Lucero et al., 2016; Parker & Toth, 1990; Peterson, 1991). For instance, Hoffman et al. (1994), in their study on men’s perpetration of IPV in Thailand, found that husbands with fewer socioeconomic resources (high financial stress) were more likely to physically abuse their wives. In another study, Lucero et al. (2016) examine the longitudinal impact of economic hardship on the incidence of IPV among 941 women in the United States of America. They found that economic hardship decreased a couple’s coping resources and that changes in household economic status predicted IPV over time. Lucero et al. were able to show that not only was absolute low economic status a stressor that was associated with male-perpetrated IPV over time, but that fluctuations in economic status also were associated with elevated IPV over time, suggesting that “the fluctuations themselves may be additive stressors on top of the actual stress of experiencing economic hardship” (Lucero et al., 2016). In contrast, a longitudinal study with over 13,000 men and women found that neither the employment status of the man nor the woman was directly linked to the odds of violence (Fox et al., 2002).

Measurement of Stress

Mirroring the general field of stress research, studies that employed stress theory to examine male IPV perpetration and/or female IPV experience operationalized stress, and other key variables, in a range of ways. Studies that employed general strain theory measured strain as dissatisfaction with financial situation and the spousal relationship, as well as experience of childhood physical abuse using a single binary measure (Cheung et al., 2014). Another measurement approach, in a study employing general strain theory, assessed polyvictimization (conventional crime, child maltreatment, sexual abuse, and peer/sibling victimization) using the Juvenile Victimization Questionnaire (Cudmore et al., 2017). General strain theory proposes that strain results in negative emotions, which, combined with poor coping mechanisms, can produce maladaptive behavior. As such, several studies using general strain theory measured anger (Cudmore et al., 2017; Davis et al., 2021), maladaptive coping (physically assaulting peers or adults, shoplifting, binge drinking, and selling drugs) (Cudmore et al., 2017; Iratzoqui & Watts, 2019) and negative emotions such as (depression, anxiety, and negative expectations) (Iratzoqui & Watts, 2019).

In studies employing life course theory, the primary focus of measurement was on exposure to violence and other ACEs, during childhood and adulthood. Studies employed gold-standard measures of experiences of violence in childhood and adulthood, assessing multiple forms of childhood experience of violence (Davis et al., 2021; Tenkorang & Owusu, 2018), including specific scales for physical violence (Kennedy et al., 2017), sexual violence (Kennedy et al., 2017), witnessing IPV (Kennedy et al., 2017; Tenkorang & Owusu, 2018), and experiences of neglect (Davis et al., 2021). Experiences of violence in adulthood also included measures of physical violence and sexual violence (Tenkorang & Owusu, 2018). Studies operationalized exposures to stressful events in a range of ways. In one study, ACEs were assessed using a binary variable for each of the 10 separate events, using a cumulative variable and then grouped into high, medium, and low exposure, and using clusters of events (abuse, neglect, and chaotic home environment) (Jones et al., 2018). In another study, the authors summed 13 different exposure items to create a cumulative violence exposure measure (Kennedy et al., 2017), and in another study, the authors created 4 different categories of exposure based on the life course stage of exposure: no experience of childhood violence or physical and/or sexual violence after age 15; no experience of childhood violence; physical and/or sexual violence after age 15; childhood violence, no experience of physical and/or sexual violence after age 15; and childhood violence and physical and/or sexual violence after age 15 (Tenkorang & Owusu, 2018).

Studies employing family stress theory focused on economic aspects of family well-being, including individual-level measures such as social class (Petersen, 1980), financial adequacy and financial well-being (Fox et al., 2002), and women’s socioeconomic resources (Rodríguez-Menés & Safranoff, 2012), whereas a study conducted in India assessed economic stress using state-level indices (i.e., human development index, calculated using state’s female literacy rate, average marriage rate, fertility rate, infant mortality rate, and female homicide rate) (Hackett, 2011). Across all studies, exposure to stressors was largely measured via self-report; one study, using disaster vulnerability theory, used residence in a particular state in India as a proxy for tsunami exposure level (Rao, 2020). Studies did not include external validation of the exposure and/or assessment of the degree of impact of the exposure, for example, by asking the respondent to rate the degree to which the stressor impacted them.

Discussion

In this systematic review of studies employing stress theories to explain predictors of male IPV perpetration and/or female IPV experience, studies primarily employed general strain theory, life history theory, and family stress theory. In contrast to existing evidence syntheses, the focus of this review is on stress as a predictor, rather than an outcome, of IPV. IPV experience is clearly a highly stressful event and process, and evidence concerning lifelong physical and mental health impacts on women indicates the urgent need to prevent IPV globally (Lagdon et al., 2014). Understanding potential predictors of male IPV perpetration and/or women’s experience of IPV is essential to developing, refining, and implementing effective prevention programming. Stress theories focusing on IPV shed light on potential individual- and community-level stressors, many of which are preventable and modifiable. The World Health Organization’s framework for preventing violence against women, RESPECT, outlines a series of evidence-based interventions that address key predictors of IPV and have been found to be effective or promising in their impact on IPV prevention (World Health Organization, 2019). Stress theories include predictors that can be addressed by several strategies within the RESPECT framework, including reduction of poverty and prevention of child and adolescent abuse. This review has identified research that employs stress theories; further analysis of this evidence-based focusing on the level of empirical support for stressors, as potentially modifiable factors to be targeted by prevention interventions, can inform program and policy development.

The included studies were identified as addressing stress theory if the authors themselves defined their research as drawing on stress theories. Some of the included articles, in particular those focused on life course theory, overlap considerably with theoretical approaches toward the role of trauma as a predictor of IPV perpetration or experience. Many ACEs, as well as experiences of violence in adulthood, can be considered traumatic events, and chronic stressors also may have the same impact on health as single traumatic events. Traumatic events can cause poor mental health (Jouriles et al., 2012), including PTSD, which has symptoms including heightened aggression and poor affect tolerance, that are in turn associated with IPV perpetration (Corvo & deLara, 2010). Trauma theories may also explain how stress exposure can heighten women’s risk of IPV experience, whereby PTSD may interfere with risk perception or result in maladaptive coping strategies that can heighten IPV risk (Iratzoqui & Watts, 2019; Stockdale & Nadler, 2012).

There is considerable overlap between life course theory and trauma theories: one of the included studies employed feminist life course theory to examine the mechanisms between ACEs and adult IPV and PTSD among incarcerated women. The findings indicate that PTSD mediated the association between ACEs and women’s risk of IPV experience (Jones et al., 2021). Integration of stress theories in general, and life course theory in particular, with trauma theories can highlight some of the mechanisms through which events—which are conceptualized within life course theory as stress, and within trauma theories as a traumatic event—may increase male perpetration of IPV or heighten women’s risk of IPV experience. Moreover, consideration of trauma theories within IPV research that employs stress theories could also lead to the integration of biomarker measurement within the evidence base (Djuric et al., 2008; Noushad et al., 2021). Physiological mechanisms between early trauma/stress exposure and subsequent IPV perpetration include that trauma/stress exposure can lead to overstimulation of the hypothalamic-pituitary-adrenal axis, resulting in over-production of cortisol, which is associated with aggressive behavior and limited impulse control (Chesworth, 2018). Integration of biomarkers within stress and IPV research could strengthen attempts to validly measure stress and elucidate mechanisms between stress and IPV.

The question of how to understand, conceptualize, and measure “coping” within research on IPV, and in particular, on predictors of men’s perpetration of IPV, is not adequately addressed in the literature identified in this systematic review. Lazarus and Folkman’s transactional theory of stress and coping emphasizes that individuals initiate coping in response to stressors, which is influenced by individual and environmental factors (Lazarus & Folkman, 1984). The transaction between the environmental and individual factors informs an individual’s capacity to “appraise, identify, respond to stress” (Keilholtz et al., 2022). Keilholtz et al. (2022) propose that within transactional theory, IPV perpetration can occur when individuals either respond to stressful emotions using IPV or view using IPV as a means to manage a stressor. Assessment of coping within research on IPV that uses stress theories is important, as not all individuals exposed to the same stressor will respond in the same way. Analysis of how individual characteristics, household- and community-level structures and supports, and broader societal influences inform coping is needed, in order to understand how individuals navigate stressors that they experience, in interaction with their environment. In particular, this systematic review’s analysis of measurement variables indicates that the vast majority of variables are self-report measures of experiencing stressful events, and largely do not assess whether individuals found the event stressful, whether they employed specific coping mechanisms, or whether they had social support when they experienced the event.

There is extensive research on predictors of male-perpetrated IPV which has employed a feminist theoretical perspective. A small number of the included articles explicitly compared feminist perspectives with stress theories. For example, Rodríguez-Menés and Safranoff (2012) contrast family stress theory with other theoretical perspectives, including the feminist perspective, economic theories of status inconsistency, and exchange theory. However, a gender perspective is lacking from many of the stress theories, including the extent to which men and women may experience particular stressors differently due to gender norms and patriarchal structures. Research on masculinity discrepancy stress indicates that this may be a factor driving male perpetration of IPV and that understanding prescribed gender norms, as well as the degree to which failure to adhere to these norms is experienced as stressful for men, is central to unpacking predictors of IPV perpetration (Reidy et al., 2014, 2015; Sileo et al., 2022).

Limitations

While representing the first comprehensive systematic review of stress theories applied to predictors of IPV, there are some limitations to this review. As noted, there is an overlap between trauma and stress theories, and it is possible that some relevant studies were not included as they referred to trauma, rather than stress. In addition, it is likely that existing relevant empirical studies were excluded, as they did not have the word “theory” or “theories” in the abstract; therefore, we cannot conclude that this review includes all empirical data on stress as a predictor of IPV. The review does not include a quality assessment, as the objective did not include assessing the strength of the existing empirical evidence for stress theories. Therefore, there is also no discussion of the methodological strengths and weaknesses of the included studies. The included studies utilized a wide range of measures for a variety of variables, and consequently in-depth analysis of the psychometrics of the measures and assessment of limitations of the measures was not possible.

Conclusion

Stress theories provide insights into potential predictors of male-perpetrated IPV. The studies identified and synthesized in this systematic review indicate that stressful events and experiences may heighten men’s propensity to perpetrate IPV and/or increase women’s risk of IPV. Overall, stress theories have not adequately engaged the gendered nature of IPV, and feminist theories should be more comprehensively integrated into research on stress and IPV. Improved measurement of stress variables, through integration of measures of perceptions of stressful experiences and biomarkers of stress, could strengthen this field of research. Research on the intersection between stress and IPV perpetration and experience has important practical implications. Women and their partners need to receive support, especially as they navigate major life changes, such as pregnancy, or other stressful experiences, such as financial insecurity. Both mental health and IPV-focused organizations need to target mental health stigma and prevailing masculinity norms so that men are more likely to seek help when faced with stressful circumstances.

Critical Findings.

Research that explores stress as a predictor of male-perpetrated IPV spans general strain theory, life course theory, occupational stress theory, vulnerability theory, and family stress theory.

The empirical studies reviewed evidenced some significant associations between stress and male-perpetrated IPV.

Measurement of stress varied, including validated measures and a wide range of self-report measures for variables including anger and economic stress. Studies did not include measures of degree of impact of the stress experience.

Note. IPV = intimate partner violence.

Implications for Practice, Policy, and Research.

Practice and policy: Although the majority of research on IPV and stress examines stress as an outcome, stress can be an important predictor of male-perpetrated IPV, and efforts to reduce and prevent IPV can account for stress at individual and community levels.

Research: Future research on stress and IPV should draw on theoretical approaches that account for individuals’ perceptions of and response to stress.

Research: The current evidence base utilizes self-report and does not assess biomarkers of stress. Incorporation of these variables could strengthen the evidence-base concerning stress and IPV.

Note. IPV = intimate partner violence.

Supplemental Material

sj-docx-1-tva-10.1177_15248380241297325 – Supplemental material for A Systematic Review of Theories of Stress as a Predictor of Intimate Partner Violence

Supplemental material, sj-docx-1-tva-10.1177_15248380241297325 for A Systematic Review of Theories of Stress as a Predictor of Intimate Partner Violence by Sarah R. Meyer, Selina Hardt, Rebecca Brambilla and Heidi Stöckl in Trauma, Violence, & Abuse

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The systematic review was supported by H2020 European Research Council (716458): ERC Starting Grant IPV_Tanzania to Prof. Heidi Stöckl.

ORCID iDs

Selina Hardt

Rebecca Brambilla

Heidi Stöckl

Supplemental Material

Supplemental material for this article is available online.

Author Biographies

Sarah R. Meyer, PhD, is a research associate at the Institute for Medical Information Processing, Biometry and Epidemiology at the Ludwig-Maximilians-Universität (LMU) in Munich, Germany where she has conducted a systematic review of theories of predictors of intimate partner violence and worked on the longitudinal pathway between food insecurity and intimate partner violence in Tanzania. Her previous work with the World Health Organization included leading efforts to improve the measurement of violence against older women and women with disabilities.

Selina Hardt, MSc, is a gender-based violence and health research associate at the Institute for Medical Information Processing, Biometry and Epidemiology at the Ludwig-Maximilians-Universität (LMU) in Munich, Germany. Her research focuses on gender-based violence and mental health, including risk and protective factors, coping, and help-seeking, specifically the role of familial, community, and system-level processes in strengthening individual and community capacity. She is also interested in the multi-disciplinary prevention of violence and trauma-related psychopathology.

Rebecca Brambilla, MSc, is a research associate at the Institute for Medical Information Processing, Biometry and Epidemiology at the Ludwig-Maximilians-Universität (LMU) in Munich, Germany. Her research focuses on biopsychosocial predictors of interpersonal violence, including domestic violence and non-partner sexual violence, such as child abuse, mental ill-health, addiction, and gender norms.

Heidi Stöckl, PhD, is a professor of public health evaluation at the Institute for Medical Information Processing, Biometry and Epidemiology at the Ludwig-Maximilians-Universität (LMU) in Munich, Germany, and honorary professor of social epidemiology at the London School of Hygiene and Tropical Medicine. Her research focuses on violence against women and girls, intimate partner homicide, and human trafficking.

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